The Three Steps to Achieving Healthy Cholesterol

Cholesterol treatment can be as easy as 1-2-3, but for effective cholesterol management, you need measurement, not guesswork. Here are the three most important considerations.

  1. Make sure your cholesterol needs treating.
  2. Medical science has known for many years that total cholesterol, LDL cholesterol, and HDL cholesterol are of limited use in predicting who will get heart disease and who will not. The really important ratio is the ratio of two different kinds of LDL-and the other numbers are all less useful.

    LDL cholesterol that is attached to a protein called apo-A does not cause heart disease. LDL cholesterol that is attached to a protein called apo-B does cause heart disease.

    You can high LDL, and if most of it is apo-A, you have no increased risk of heart disease. You can have low LDL, and if most of it is apo-B, you have a sharply increased risk of heart disease. Before you start any program of treatment that can cause side effects and cost you thousands or even tens of thousands of dollars, make sure you need treatment. And don’t rely on total cholesterol, HDL, and total LDL numbers to make your decision.

  3. Treat high cholesterol with diet first.
  4. Ironically, the way traditional cholesterol testing is done, the better your diet, the worse your cholesterol. Not only does the LDL number you get back from the lab not predict your risk of heart disease, it’s only an estimate. Most labs don’t measure LDL, they estimate it.

    If you go on a reduced-calorie or reduced-sugar diet, your triglycerides will go down, and when your triglycerides go down, the way the formula works, your estimated LDL will go up. Don’t let your doctor give you a cholesterol medication you don’t need. Insist on direct measurement of cholesterol.

    Once you are sure your cholesterol really is high, then avoid fasting and avoid low-fat diets. Why? Unless you get some monounsaturated fat in your diet, such as is in nuts and olive oil, your cholesterol levels will go up. If there is no other fat in your bloodstream, the fat released from your fat cells to be burned elsewhere in the body will tend to be processed as cholesterol, raising cholesterol levels, rather than lowering them. You need to reduce calories, but you also need to increase monounsaturated plant fats. And you need to make sure you are getting sophisticated cholesterol testing.

  5. If you take cholesterol medication, be sure to take fish oil and coenzyme Q10.
  6. If you really have elevated apo-B, then you probably actually do need statin medications. Statins work by stopping the creation of cholesterol in the liver. Interfering with these enzymes, however, also interferes with the production of heart-protective coenzyme Q10. As important as healthy cholesterol is stopping inflammation, with the help of products that are rich in omega-3 essential fatty acids such as fish oil and microalgae, and providing the heart with the coenzyme Q10 it needs to operate normally even when oxygen supply is poor.